Boston Just got a lot more expensive(maybe) (Read 1103 times)

My wife had to visit the med tent and they placed her in an ambulance to do so while on the course. We got a bill today for a little over 2000 dollars for the half mile ride, an IV, and oxygen. Yow! We have insurance but since we never have had any emergencies like this what should we expect to have to pay since this was during a race(does it matter)?

The race part shouldnt matter. Your insurance company may try to balk if the ambulance company/any treating physicians etc. (was there an ER?, or just ride to another station?) are not in network, but you CAN fight this and if you are persista\ent you will usually win. (i.e. you were not given a choice of service providers and it was an emergency situation, etc.)

They may fight a lot. Fight back and do not freaking pay one red cent until you have exhausted your options with insurance to cover your normal emergency service amount (i.e I would pay $100 for emergency care). Keep the billing companies in the loop on your fight and they will often join in on the fight because they know they wont get paid until they do. Once you send them money, no one will help you. Also if you keep them in the loop they often will not charge any service fees while you are still fighting insurance.

(yes I have been through this. DH was life-flighted to an ER that was out of network and it took several months and phone calls but they eventually paid all of the $30,000 bill minus the $100 copay. )

Step one is to provide the insurance info to the billing companies and ask them to submit through normal channels.

I have become Death, the destroyer of electronic gadgets

"When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

I would think your Ins. would be willing to play nice. Several years ago I ended up in the ER (on our anniversary) while visiting my ILs out of state over Christmas. I had a flu that developed into pneumonia and necessitated a breathing treatment and antibiotics (as if spending time with my MIL weren't misery enough). I don't recall our insurance being too difficult with this.

Copays and deductibles are all it should amount to in the end. Definitely push back against any charge. It's in the insurance company's best interest to bill for as much as possible and just hope you pay it without question. That's how they make the most money. When pushed, though, they should back off on almost everything.

Sorry to hijack, but as long as we are talking about health insurance...

We're moving from Canada back to the US. (We're American.) Here, everybody is covered, no fuss, no muss. In the US, we are both going to be self employed. For the first time, we'll have to find our own health insurance.

So, uh... how does that work, exactly? Any recommendations? We'll be living in California, if that matters.

xor

posted: 5/3/2012 at 12:34 PM

Welcome to hell.

I filled out some forms via ehealthinsurance.com... it presented me with a variety of plans and I picked. A couple years later when that plan revealed itself to suck just a little too much, I re-did the process.

Once you pick a plan.... you THEN go through the application process with that specific company (my current company is Lifewise of WA). Your application process will likely be easier than mine.

NOW... it varies state to state. No idea what you might find in CA vs what I have in WA. If you are lucky, it will be better. And do not hesitate. What you want to avoid is a gap in coverage. Too much of a gap and gnarly 'pre-existing condition' checks start coming into play. Whereas with no gaps, they can't really hose you about PEC. Well, that's true about no gaps in US-focused coverage. I honestly don't know how they look at it when you come in from a vastly foreign land. Like Canada.

ditto on ehealth as a place to start. But also check around the area you are living to see what the majority of places take. Cheaper plans suck ass if your hospital doesnt take them. there is one around here that is GREAT as long as you live IN downtown portland and never ever leave downtown. Or need a specialist.

Avoid Kaiser. JMO. They can be a lot cheaper and service can be great right up until the moment something is seriously wrong then they suck.

I have become Death, the destroyer of electronic gadgets

"When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

bhearn, my sympathies. My husband and I are self-employed. The only game in town here is Anthem Blue Cross. They've rigged the premiums so it makes sense only purchasing the plan with a very high deductible ($5,000). Our two sons require thousands and thousands of dollars of medical care each year, but even for them the $5,000 deductible is the way to go.

Do NOT be suckered into plans such as Mega Life & Health offers. The premiums are lower, but they don't negotiate rates with providers. So if a doctor charges $170 for a visit and services, we might pay $70 through Anthem, but it would be $170 through Mega (if the deductible hasn't been met yet). We learned that lesson the hard way.

NOW... it varies state to state. No idea what you might find in CA vs what I have in WA. If you are lucky, it will be better. And do not hesitate. What you want to avoid is a gap in coverage. Too much of a gap and gnarly 'pre-existing condition' checks start coming into play. Whereas with no gaps, they can't really hose you about PEC. Well, that's true about no gaps in US-focused coverage. I honestly don't know how they look at it when you come in from a vastly foreign land. Like Canada.

Actually, if you're not in a large group plan, the pre existing condition issue can pose a problem even without a gap in coverage. How much of a problem depends on the state. If the Affordable Health Care Act stays in force, I think that becomes less of an issue in a couple of years (2014?) But goodness knows we don't want none of that crazy socialist Canadian-type health care down here. We prefer for people to go bankrupt when they get sick.

Bob, if you plan to use a payroll company you can get different plans through them. Also, your town's Chamber of Commerce might offer something if you join.

I used a local Professional employer organization to get both health and worker's compensation insurance. If you don't need WC then PEOs start losing luster, especially if they require you to carry it even though you're a self-employed desk-job kind of person.

But I recommend you just subcontract all your insurance wrangling out to Ennay.